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Bipolar Disorder: Managing the Balancing Act

Bipolar disorder symptoms include dramatic shifts in mood and the ability to function. Successful bipolar disorder treatment requires a careful course of medication, psychotherapy, and discipline to stay on track--and avoid an emotional crash

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Medicating Mania

Bipolar disorder can't be cured but is typically treated with medication, psychotherapy, and lifestyle changes. Doctors often treat the mania symptoms with one set of drugs, and use other drugs to treat the depression. Maintenance treatment with a mood stabilizer such as lithium or an anticonvulsant drug can substantially reduce the number and severity of episodes for most people, but this can be a tough pill to swallow.

Why? Because many people with bipolar disorder struggle with the idea of staying on their medication for life. Some even enjoy the initial phases of the manic stage, while others feel fine and don't want to deal with the side effects of the medications, which can include weight gain and sexual problems.

Having been on lithium for 10 years, Molliner says, "I didn't have that choice [about treatment], because I was 16 at the time of diagnosis. [But] the peak of the mania and the deepest end of the depression were so scary and big that I never wanted to experience them again. In the manic stage, I was totally out of control in my own mind and body, and that is the scariest experience ever," she recalls. "And the depression felt like death.

"The biggest issue with the lithium for me was that it triggered [the skin condition] psoriasis, and I developed a slight hand tremor. But there were no sexual side effects," she says. Weight gain was an issue, though. "For the first six years [of treatment] I could not lose weight for the life of me, but finally my body adjusted."

Balancing Act

One of the concerns voiced by those with bipolar disorder is that medication will wipe out their ability to feel joy and express creativity. Like many artistic types, Maurice Bernard, the Emmy Award-winning actor who for 13 years has played General Hospital's tempestuous mobster, Sonny Corinthos, at first feared that going on lithium would affect his productivity -- and his livelihood.

"If you're an actor, people think if you take medication for bipolar disorder you won't be able to creatively do the work," Bernard tells WebMD. His track record refutes this notion. He received the Emmy for Outstanding Lead Actor in a Daytime Drama Series in 2003 and was also nominated in 1996, 1997, 2004, and again in 2005.